Effect of coffee intake on blood pressure in male habitual alcohol drinkers.

Many cross-sectional epidemiological studies have revealed that alcohol consumption is closely related to an increase in blood pressure, which is known to be associated with an elevated serum gamma-glutamyltransferase (GGT) level, rather than to the volume of alcohol consumed. Since recent studies showed that coffee intake is inversely related to serum GGT, we investigated the effect of coffee on blood pressure in habitual alcohol drinkers. A total of 42 male hypertensive or prehypertensive volunteers who consumed alcohol and coffee daily completed this randomized controlled crossover trial. After a 2-week baseline period, these participants were randomly assigned to either a coffee-drinking group or a non-coffee-drinking group for the first 4 weeks. The situation was then reversed for the next 4 weeks. All participants continued their usual alcohol consumption. Blood pressure was measured once a week and compared between the two groups. After 1 week of coffee intake of more than 3 cups per day, the systolic and diastolic blood pressure began to fall slowly, and cessation of coffee intake raised the blood pressure. Systolic blood pressure was lowered by 7-10 mmHg, and diastolic pressure by 3-7 mmHg in 4 weeks. Alcohol consumption of more than 60 ml per day was maintained and there were no lifestyle changes in the participants of either group throughout the study period. Analyses of urine electrolytes and urea nitrogen indicated that there were no significant dietary changes. In conclusion, coffee intake of more than 3 cups per day in hypertensive and prehypertensive men who regularly consume alcohol lowers blood pressure.     

Age-dependent association of alcohol drinking with pulse pressure

BACKGROUND: Wide pulse pressure is a potent risk factor for atherosclerotic disease, and hypertension is induced by habitual alcohol drinking. This concise study investigated whether age affects the relationship between alcohol drinking and pulse pressure. METHODS: The participants were 99 661 male workers (20-69 years old) who had received periodic health check-ups. The mean levels of pulse pressure and blood pressure were compared among three different groups divided by the average amount of daily alcohol intake (nondrinkers; light drinkers, < 30 g ethanol/day; heavy drinkers, >or= 30 g ethanol/day) in each age group. RESULTS: The mean pulse pressure was decreased in the thirties and forties age groups compared with that in the twenties age group, and then was increased with advance of age in the fifties and sixties age groups. Pulse pressure was significantly wider in heavy drinkers than in nondrinkers and light drinkers in all age groups, and the difference between pulse pressure of nondrinkers and that of heavy drinkers was greater in the fifties and sixties age groups than in the younger groups. Pulse pressure in light drinkers was significantly wider than that in nondrinkers in the fifties and sixties age groups but was not different from that in nondrinkers in the twenties to forties age groups. CONCLUSIONS: Association of alcohol intake with pulse pressure is dependent on the amount of alcohol and is stronger in the elderly. Age as well as amount of alcohol intake should therefore be taken into account when the influence of alcohol drinking on pulse pressure is considered.     

Erythrocyte volume and blood pressure in a cross-sectional population-based study

A reduction in mean erythrocyte volume has been reported in some strains of genetically hypertensive rat, and more recently it has been suggested that a similar alteration might be found in human essential hypertension. The relationship between erythrocyte volume and blood pressure was therefore studied in a random sample of an untreated male working population (n = 317; age 45.1 +/- 6.4 years, mean +/- s.d.). Neither systolic nor diastolic blood pressures were found to be related to erythrocyte volume (r = 0.022 and r = -0.014, respectively); in fact, erythrocyte volume was not different across quintiles of blood pressure. Smokers (n = 171) had lower blood pressure and a greater erythrocyte volume than non-smokers or ex-smokers (n = 144; 91.6 +/- 4.7 versus 88.2 +/- 5.5 fl; P less than 0.001), and heavy drinkers (greater than 110 g ethanol/day) had higher blood pressure and a greater erythrocyte volume compared with the rest of the study population (P less than 0.01). However, after adjustment of erythrocyte volume for these two potentially confounding factors, again no statistical association was found with blood pressure. The present study, therefore, does not support the hypothesis of a negative association between erythrocyte volume and blood pressure, whereas it confirms that the smoking habit and habitual alcohol intake are strong determinants of erythrocyte volume.     

Interaction of alcohol and an alpha1-blocker on ambulatory blood pressure in patients with essential hypertension

Ingestion of alcohol acutely decreases vascular resistance and blood pressure (BP) with activation of the sympathetic nervous system in Orientals. Although alpha1-blockers are widely used in the treatment of hypertension, the possible interaction between alcohol and alpha1-blockers has not been clarified. We examined the effects of prazosin on the alcohol-induced BP changes in Japanese men with mild hypertension. Ten hypertensive patients (54 +/- 3 years, mean +/- SE) were given 1 mL/kg of alcohol or isocaloric control drink with a light meal in the evening before and 5 to 7 days after treatment with prazosin (1 mg three times daily). Ambulatory BP monitoring was carried out every 30 min for 24 h in each period using Colin ABPM-630. Blood samples were obtained before and 2 h after intake of alcohol or control drink. Before prazosin treatment, alcohol ingestion decreased BP for several hours with a significant reduction in average 24-h BP, whereas it increased heart rate, plasma norepinephrine, and plasma renin activity. Treatment with prazosin caused a significant decrease in 24-h BP (136.3 +/- 4.0/82.8 +/- 2.5 v 131.6 +/- 3.2/80.0 +/- 2.3 mm Hg). The alcohol-induced hypotension at 2-4 h after ingestion was enhanced by prazosin (-18.0 +/- 3.7/-11.8 +/- 2.7 v -24.4 +/- 4.9/-17.8 +/- 2.8 mm Hg, P < .05 for diastolic BP). These results suggested that inhibition of the sympathetic nervous system with alpha1-blockers accentuates alcohol-induced hypotension. Ingestion of alcohol may cause a marked BP reduction in hypertensive Orientals treated with alpha1-blockers.     

Dietary alcohol, calcium, and potassium. Independent and combined effects on blood pressure

To determine whether or not the previously reported association between alcohol intake and high blood pressure is influenced by differential intake of calcium and potassium in drinkers compared with nondrinkers and to assess the magnitude of the independent contributions of alcohol, calcium, and potassium to blood pressure, these associations were evaluated in 7,011 men of Japanese descent. Categorical analyses and multiple linear regression techniques were used to test the hypotheses that alcohol, calcium, and potassium were independent predictors of blood pressure. Alcohol consumption above a threshold of approximately 20 ml/day was found to be positively, strongly, and independently correlated with systolic and diastolic pressures, and this effect was completely independent of the effects of calcium and potassium. Calcium and potassium intake were highly correlated (r = 0.59) and were inversely related to blood pressure, and their combined effect was greater than the effect of either alone. However, in the subgroup of moderate and heavier drinkers, only potassium was inversely related to blood pressure. This finding is compatible with previous reports of malabsorption and increased excretion of calcium at higher levels of alcohol intake, and it indicates that a small portion of the alcohol-induced blood pressure elevation may be mediated through calcium depletion. In the range of dietary intake in this cohort, the effect of alcohol on blood pressure was stronger than was either the separate or combined effects of calcium and potassium.     

Effects of alcohol intake on endothelial function in men: a randomized controlled trial

BACKGROUND: Regular light consumption of alcohol appears to reduce the risk of cardiovascular disease, whereas in heavier drinkers the opposite effect is seen. This biphasic relationship could partly be due to contrasting actions of low and high alcohol intake on endothelial function. OBJECTIVE: To determine whether reducing alcohol intake in moderate-to-heavy drinkers (40-110 g/day) would improve conduit artery endothelial function as assessed by post-ischaemic brachial artery flow-mediated dilatation (FMD). METHODS: In a two-way cross-over study, 16 healthy men either substituted their usual alcohol intake with a 0.9% alcohol beer or maintained their usual alcohol intake during sequential 4-week periods. At the end of each period of FMD and glyceryl trinitrate-induced brachial artery dilatation, blood pressure, plasma lipids, homocysteine and biomarkers of alcohol consumption (gamma-glutamyl transpeptidase) and endothelial function (E-selectin, von Willebrand factor, endothelin-1) were assessed. RESULTS: The participants reduced their alcohol intake from 72.4 to 7.9 g/day. This self-reported reduction in alcohol intake was corroborated by significant decreases in gamma-glutamyl transpeptidase (24%). The decrease in alcohol intake resulted in reductions in total cholesterol (5%), high-density lipoprotein cholesterol (17%), homocysteine (9%) and systolic and diastolic blood pressure [5 mmHg (P = 0.01) and 4 mmHg (P = 0.003), respectively]. There was no effect of alcohol on FMD (6.23 +/- 0.75% compared with 6.24 +/- 0.71%, P = NS), glyceryl trinitrate-induced vasodilatation, E-selectin, endothelin-1 and von Willebrand factor. CONCLUSION: Substantial reduction in alcohol intake in healthy moderate-to-heavy drinkers does not improve endothelial function as measured by post-ischaemic flow-mediated dilatation of the brachial artery or biomarkers of endothelial function.     

Sex differences in casual and ambulatory blood pressure responses to extreme changes in dietary sodium

OBJECTIVE: To compare the awake ambulatory and seated casual blood pressure responses to extreme changes in dietary sodium during a 4-month period between borderline hypertensive men (n = 24, aged 51+/- 7 years) and women (n = 8, aged 47+/- 8 years). METHODS: Seated casual and awake ambulatory (over an average of 9 h, n = 32 readings) blood pressures were recorded at the end of 1-month trials of low (24 +/- mmol/day for men, 32 +/- 19 mmol/day for women) and high (330 +/- 101 mmol/day for men, 298 +/- 76 for women) intakes of dietary sodium. There was a 1-month interim period between the two trial periods and energy and potassium intake were maintained constant over the entire course of the study. RESULTS: Among men, there was a similar average increase in blood pressure on going from the low- to the high-sodium diets according to the two methods of measurement, but among women there was a significant difference between the methods, such that the change in ambulatory blood pressure was less than the change in casual blood pressure. Women's casual blood pressure increased by 14/7 mmHg more than did their ambulatory blood pressure, whereas men's ambulatory blood pressure increased by 5/2 mmHg more than did their casual blood pressure (sex difference P < 0.009 for systolic and P < 0.037 for diastolic blood pressures). Finally, there was at best only modest concordance between changes in casual and ambulatory blood pressures between diets in individual patients, regardless of their sex, although men were more likely to have similar changes in their casual and ambulatory measurements than were women. CONCLUSION: The determination of the sensitivity of blood pressure to dietary sodium intake may depend upon how blood pressure is measured. There may also be an interaction between sex and blood pressure measurement technique that could affect the determination of salt-sensitivity differences between men and women.     

Relationship between ambulatory blood pressure monitoring and response of blood pressure in male hypertensive adolescents to exercise

BACKGROUND: High blood pressure in the young has been related to the development of hypertension in adults; hence the importance of identifying adolescents with the risk of developing it.OBJECTIVE: To investigate the relationship between 24 h ambulatory blood pressure monitoring and the response of blood pressure in adolescents to exercise. DESIGN: A prospective and cross-sectional study. METHODS: We classified 101 men aged 13-18 years as obese hypertensive, lean hypertensive, obese normotensive, and lean normotensive. Mean blood pressure and variability were measured with ambulatory blood pressure monitoring, and expressed as 24 h, awake, and sleeping periods. Treadmill tests were also performed. RESULTS: Hypertensives and obese normotensives had higher ambulatory blood pressure monitoring values (P< 0.0001). Systolic blood pressure during sleep in obese subjects was significantly higher than that in lean usbjects (119.9 +/- 9 versus 113.6 +/- 8 mmHg, P < 0.001, obese hypertensives versus lean hypertensives; and 113.6 +/- 2 versus 103.0 +/- 2 mmHg, P < 0.002, obese normotensives versus lean normotensives) and nocturnal drop of systolic blood pressure was lower in obese subjects. We found a significant correlation between systolic blood pressure during ambulatory blood pressure monitoring and systolic blood pressure during moderate and maximal exercise for all periods (P < 0.0001). Blood pressure variability during awake period was higher in subjects with maximum exercise systolic blood pressure >/= 200 mmHg (7.4 +/- 2 versus 6.4 +/- 2%, P < 0.01).CONCLUSION: Systolic blood pressure measured by ambulatory blood pressure monitoring is related to response of systolic blood pressure to exercise and ambulatory blood pressure monitoring can identify groups of subjects at greater than normal risk through their higher blood pressure during sleep. Greater than normal blood pressure variability in adolescents is an indicator of the risk of reaching abnormal exercise values of systolic blood pressure. Higher casual blood pressure than ambulatory blood pressure monitoring values for adolescents should be considered abnormal.     

Plasma atrial natriuretic peptide in essential hypertension. Comparison with normotensive subjects and effects of changes in dietary sodium intake

Plasma levels of atrial natriuretic peptide (ANP) in 106 patients with essential hypertension with a supine mean blood pressure (mean +/- SEM) of 128.9 +/- 1.6 mmHg and not on treatment were significantly higher than those in 47 normotensive subjects (supine mean blood pressure 93.9 +/- 1.2 mmHg) with mean values of 17.2 +/- 1.1 and 8.6 +/- 0.6 pg/ml, respectively (P less than 0.001). Similar results were found in a subgroup of 35 hypertensive patients identically matched in terms of age, sex, and race with 35 normotensive subjects. Plasma levels of ANP were correlated significantly with age in normotensive subjects and with age and blood pressure in the hypertensive patients. In 12 hypertensive patients studied on a low (10 mmol sodium/day), on their usual sodium intake (around 120 mmol sodium/24 hr) and on a high (350 mmol sodium/day) intake, plasma ANP increased approximately twofold by the fifth day of the high sodium intake, but there was no significant difference between the plasma levels on their usual sodium intake and those on the fifth day of the low sodium intake. Supine mean blood pressure on the patients' usual sodium intake was 119.3 +/- 2.7 mmHg and was reduced to 110.0 +/- 3 mmHg by the fifth day of the low sodium intake (P less than 0.005). However, there was no significant difference between the blood pressure levels on their usual and high sodium intake (118.3 +/- 3.0 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of alcohol withdrawal on blood pressure in hypertensive heavy drinkers

BACKGROUND: Epidemiological investigations have demonstrated a close association between heavy alcohol consumption and hypertension. The mechanisms of this association, however, remain elusive. We studied the effects of alcohol withdrawal on blood pressure, hormonal parameters, and circulating markers of endothelial activity. METHODS: In 14 hypertensive heavy alcohol consumers (> 200 g/day) who agreed to participate in a hospital withdrawal programme we monitored, for 30 days, blood pressure, plasma levels of renin, aldosterone, cortisol, endothelin, and plasminogen activator inhibitor 1 (PAI-1), and urinary levels of catecholamines. Patients in the withdrawal group were compared with eight hypertensive heavy drinkers who refused to participate in the programme and maintained regular alcohol consumption and 11 normotensive teetotalers. RESULTS: By the third day after withdrawal, blood pressure was significantly decreased and the normalization of levels was obtained in 13 of 14 patients by the end of the study. Alcohol withdrawal significantly decreased plasma aldosterone and cortisol levels, but did not affect levels of active renin and fractionated urinary catecholamines. At baseline, plasma endothelin and PAI-1 levels were significantly higher in alcoholic individuals than in teetotalers, and after the cessation of alcohol intake decreased progressively, reaching levels different from baseline within 1 week. A significant correlation was found between changes in endothelin and PAI-1, and blood pressure variations during alcohol abstinence that remained significant only for endothelin with the multivariate approach. CONCLUSION: Hypertension is rapidly reversible in the majority of heavy drinkers after the withdrawal of alcohol consumption. In these patients, hypertension is associated with an increased release of endothelial factors that might contribute to the increase in blood pressure.     

Twenty-four-hour blood pressure profiles in normotensive sons of hypertensive parents.

We investigated whether blood pressures are higher in normotensive offspring of hypertensive parents than in normotensive offspring of normotensive parents outside the physician's office and, if so, whether these higher blood pressures are dependent on the level of dietary sodium intake. We compared 24-hour ambulatory blood pressure profiles between 11 normotensive sons of two hypertensive parents and 11 normotensive sons of two normotensive parents; profiles were recorded after 1 week of a low sodium diet (10 meq/day) and after 1 week of a high sodium diet (200 meq/day). The sons of hypertensive parents were on average 6 years older than the sons of normotensive parents (47 +/- 5 [SD] versus 41 +/- 4 years, p < 0.05). The shift from low to high sodium diet did not significantly change the magnitude of differences in office or ambulatory blood pressures between the groups (i.e., no group-by-diet interaction); thus, we assessed group effects by contrasting blood pressure means for each group pooled across diets. Age-adjusted office blood pressure was higher in sons of hypertensive parents than in sons of normotensive parents (116 +/- 7/80 +/- 6 versus 111 +/- 7/75 +/- 6 mm Hg; p = 0.020 for systolic and p = 0.003 for diastolic blood pressure).(ABSTRACT TRUNCATED AT 250 WORDS)     

Association between alcohol intake and development of hypertension in Japanese normotensive men: 12-year follow-up study

Although it has been suggested that alcohol intake is related to hypertension, few long-term prospective studies have investigated this relationship. We therefore conducted a prospective study in male residents of a farming community in Japan to determine whether heavy drinking would predispose to the development of hypertension. A total of 325 normotensive (< 140/90 mm Hg) men were enrolled in 1977. Twelve years later, 93 (28.6%) subjects became hypertensive (defined as blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication). The probability of the development of hypertension in heavy drinkers predicted from a logistic regression equation was 44.6% (relative risk: 2.05 versus nondrinkers) after adjusting for age and body mass index (BMI). It was 36.2% (relative risk: 1.86 versus nondrinkers) after a further adjustment for systolic blood pressure at baseline. A high odds ratio of 2.39 for the development of hypertension with alcohol intake of < 46 g/day versus ≥ 46 g/day at baseline was obtained even after adjustments for age, BMI, and confounding factors. We conclude that habitual heavy drinking of alcohol is a risk factor for the development of hypertension. This is the first report demonstrating a significant relationship between habitual alcohol intake and the development of hypertension in a long-term prospective study in Japan.     

Eating habits and intensity of medication in elderly hypertensive outpatients.

Several dietary factors have been shown to lower blood pressure in elderly patients in clinical trials, but it is not known how eating habits affect blood pressure control in outpatients treated with antihypertensive drugs. We obtained data on dietary information regarding food groups rich in potassium, magnesium, and calcium by submitting a questionnaire to 190 elderly outpatients. Blood pressure levels and the intensity and cost of antihypertensive treatment were obtained from clinical records. The mean age and blood pressure were 72.3 +/- 9.3 years and 138.7 +/- 15.2/74.6 +/- 8.8 mmHg, respectively. Patients were divided into three groups on the basis of the intensity of medication: the LS group (n=52), treated with a low dose of a single drug; the HS group (n=95), treated with a high dose of a single drug; and the M group (n=43), treated with multiple drugs. Average age, body mass index, blood pressure levels, and extent of target organ damage were similar among the three groups. Intake frequency (rarely, once or twice per week, 3 to 6 times per week, or every day) of the food groups was compared among the three groups. The LS group ate fruit (p < 0.05) and seaweed (p < 0.01) with significant frequency compared with the other groups, whereas milk and dairy products were taken with similar frequency by all groups. The monthly cost of antihypertensive medications averaged 17,218 +/- 620 yen in the LS group, 17,746 +/- 375 yen in the HS group, and 20,066 +/- 1,364 yen in the M group. These data suggest that habitual intake of foods rich in potassium and magnesium are associated with reduced intensity and cost of medication and with preservation of blood pressure control in elderly hypertensive outpatients.     

Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men but not in middle-aged men

BACKGROUND: Both blood pressure and HDL cholesterol are affected by alcohol drinking. However, it has not been determined whether association of alcohol drinking with blood pressure varies depending on blood HDL level. METHODS: The subjects were male workers aged 20 to 29 year and 50 to 59 year (n = 21,301), representing young and middle ages, respectively, who had received periodic health checkup examinations. The subjects were divided into tertile groups by serum HDL level, and they were further divided into 3 subgroups based on the average daily alcohol intake [nondrinkers, light drinkers (<30 g of ethanol per day) and heavy drinkers (30 g or more of ethanol per day)]. Blood pressure and incidence of high blood pressure were compared among the 3 alcohol subgroups in each age and HDL group. RESULTS: In the lowest HDL tertile of 20 to 29-year-old subjects, systolic and diastolic blood pressure and incidences of high systolic and diastolic blood pressure were not significantly different among the 3 alcohol subgroups. In the middle and highest HDL tertiles of the twenties age group, systolic and diastolic blood pressure was significantly higher in heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers. On the other hand, in all HDL tertile groups of 50 to 59-year-old subjects, blood pressure was significantly higher in light drinkers and heavy drinkers than in nondrinkers, and incidences of high systolic and diastolic blood pressure were significantly higher in drinkers than in nondrinkers. CONCLUSIONS: The results suggest that blood pressure of middle-aged men is elevated by alcohol drinking independently of blood HDL level and is more sensitive to drinking than is blood pressure of young men.     

Alcohol stimulation of renin release in man: its relation to the hemodynamic, electrolyte, and sympatho-adrenal responses to drinking

Alcohol stimulation of the renin-angiotensin axis has been proposed as an explanation for the higher blood pressure in drinkers. This study examines the acute effects of moderate alcohol intake on PRA in relation to change in fluid and electrolyte balance, sympatho-adrenal activity, blood pressure, and heart rate in 20 normal men, aged 20-24 yr. They consumed either 750 ml nonalcoholic beer as a control or the same beverage with 1 ml/kg alcohol added, which increased the plasma alcohol concentration to 16.7 +/- 1.0 (+/- SE) mM within 70 min. PRA increased more than 2-fold 90 min after the ingestion of alcohol. This was accompanied by a decrease in diastolic blood pressure and a fall in plasma potassium, both possible stimuli to the rise in PRA. A late increase in plasma sodium, also occurring 90 min after alcohol ingestion, was attributed to plasma volume contraction after an alcohol-induced diuresis. This may have been an additional factor in stimulating renin release. Norepinephrine levels increased during both alcohol and control studies. In contrast, plasma epinephrine decreased significantly during the control study, but did not change after alcohol ingestion. Hence, alcohol stimulation of sympathetic nervous activity is unlikely to have mediated the renin release. We conclude that the acute increase in PRA associated with moderate alcohol consumption is predominantly a secondary response to changes in fluid and electrolyte balance and blood pressure. Although a direct action of alcohol on renin release was not excluded, the possibility that repeated activation of the renin-angiotensin system mediates the pressor effect of regular moderate alcohol consumption is, therefore, diminished.     

Effects of alcohol restriction on ambulatory blood pressure,heart rate,and heart rate variability in Japanese men

We investigated the effects of alcohol restriction on ambulatory blood pressure (BP), heart rate, and heart rate variability in 33 Japanese male volunteers (37 ± 1 years, mean ± SE), who were all habitual drinkers. Subjects were told either to keep their usual drinking habits for 3 weeks (usual alcohol period), or to reduce alcohol intake by at least half of their usual drinking amount (reduced alcohol period). The ambulatory BP, heart rate, and electrocardiographic R-R intervals were measured during a 24-h period with a portable recorder on the last day of each period. A power spectral analysis of R-R intervals was performed to obtain the low-frequency (LF) and high-frequency (HF) components. The percentage of differences between adjacent normal R-R intervals >50 msec (pNN50) was also calculated. The amount of ethanol intake was significantly reduced from 70 ± 5 mL/day in the usual alcohol period to 19 ± 3 mL/day in the reduced alcohol period (P < .0001). The daytime systolic BP was significantly lower in the reduced alcohol period than in the usual alcohol period by 4 ± 1 mm Hg (P < .05). The daytime and nighttime heart rate was significantly lower in the reduced alcohol period than in the usual alcohol (P < .001 for each). The pNN50 and the HF component were significantly higher in the reduced alcohol period than in the usual alcohol period (P < .0001 for each). The LF/HF ratio was significantly lower in the reduced period than in the usual period (P < .01). These results demonstrate that 3-week alcohol restriction produced reductions in ambulatory systolic BP, heart rate, and the index of sympathovagal balance, and augmentations of parasympathetic indices of heart rate variability in Japanese male drinkers.     

The role of sex hormones and sodium intake in postmenopausal hypertension.

To determine the role of sex hormones and sodium intake in hypertension seen in postmenopausal woman, 12 women (aged 50 to 59 years) in whom blood pressure increased for the first time to above 150/90 mmHg after cessation of menstruation were examined in comparison with 7 age-matched postmenopausal normotensive women (118 +/- 2/62 +/- 3 mmHg). All subjects were admitted to the hospital and their sodium intake was maintained at 204 (normal), 306 (high), and 51 (low) mmol/day for 5 days each. In each period, body weight, blood pressure, heart rate, serum levels of sex hormones and vasoactive hormones, and urinary excretions of sodium, kallikrein and dopamine were determined. The plasma levels of prolactin, progesterone, oestrone, and oestradiol in the hypertensive women were all significantly lower than those in the normotensive women in all study periods. With a change in sodium intake from high to low, blood pressure in 8 out of 12 hypertensive patients decreased by more than 10% from 160 +/- 2/100 +/- 2 mmHg to 144 +/- 2/87 +/- 2 mmHg, while in the normotensive women, only 1 out of 7 patients responded to this change in sodium intake. The changes in sodium intake did not alter the plasma levels of sex hormones in the hypertensive and normotensive subjects. Among the hypertensive patients, three had a history of pregnancy-induced hypertension, while none of the normotensive subjects had such a history. The results of the present study suggest that decreases in sex hormones and increased sensitivity to sodium are important factors in the genesis of postmenopausal hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ambulatory blood pressure monitoring in patients with panic disorder

To assess possible changes in blood pressure and heart rate associated with panic attacks, we performed automatic ambulatory blood pressure monitoring in 12 newly diagnosed, drug-free, and normotensive (casual blood pressure, less than 140/90 mm Hg) medical patients recently diagnosed with panic disorder. Detailed journals were designed for the study to assess the timing and symptoms of the panic attacks and the levels of activity. Systolic blood pressure increased by 27 +/- 9 mm Hg during the hour of the panic attack compared with the hour immediately prior to the episode of anxiety, while diastolic blood pressure increased by 5 +/- 2 mm Hg. The ambulatory heart rate increased by 14 +/- 6 beats per minute during the hour of panic attack vs the hour immediately prior to the attack. There was a strong relationship between the increase in heart rate and increase in systolic blood pressure. These data confirm that normotensive patients with panic disorder have episodically hypertensive blood pressure readings associated with an increase in heart rate; these hemodynamic alterations appear to be secondary to their panic attacks and not to increased physical activity. However, despite these episodic "hypertensive" periods, the mean ambulatory blood pressures remain within the normotensive range.     

Effects of coffee on ambulatory blood pressure in older men and women: A randomized controlled trial

This study assessed the effects of regular coffee drinking on 24-hour ambulatory blood pressure (ABP) in normotensive and hypertensive older men and women. Twenty-two normotensive and 26 hypertensive, nonsmoking men and women, with a mean age of 72.1 years (range, 54 to 89 years), took part in the study. After 2 weeks of a caffeine-free diet, subjects were randomized to continue with the caffeine-free diet and abstain from caffeine-containing drinks or drink instant coffee (5 cups per day, equivalent to 300 mg caffeine per day) in addition to the caffeine-free diet for a further 2 weeks. Change in systolic and diastolic blood pressures (SBP, DBP) determined by 24-hour ambulatory BP monitoring showed significant interactions between coffee drinking and hypertension status. In the hypertensive group, rise in mean 24-hour SBP was greater by 4.8 (SEM, 1.3) mm Hg (P=0.031) and increase in mean 24-hour DBP was higher by 3.0 (1.0) mm Hg (P=0.010) in coffee drinkers than in abstainers. There were no significant differences between abstainers and coffee drinkers in the normotensive group for 24-hour, daytime, or nighttime SBP or DBP. In older men and women with treated or untreated hypertension, ABP increased in coffee drinkers and decreased in abstainers. Restriction of coffee intake may be beneficial in older hypertensive individuals.